Treatment of Dupuytren’s Contracture
The treatment of Dupuytren’s contracture depends on the severity of the condition and how much it affects hand function. In early stages, when the nodules are small and the fingers can still straighten fully, treatment may not be necessary. In such cases, regular monitoring and lifestyle adjustments are usually enough. However, once the fingers begin to curl and limit everyday tasks, active treatment of Dupuytren’s contracture becomes essential.
One of the main goals of treatment is to restore movement and prevent further progression. Non-surgical options include steroid injections to reduce inflammation and slow tissue thickening. These are often used when the nodules are still soft and the contracture is not yet severe. Another method involves enzyme injections—specifically collagenase—which breaks down the cords responsible for pulling the fingers inward. This procedure, followed by manual manipulation, can offer good results with minimal downtime.
In more advanced cases, surgery may be the best option. The most common surgical procedure is fasciectomy, where the surgeon removes the thickened cords and scarred fascia from the palm. This allows the fingers to straighten. In some cases, a skin graft may be required if a large area of tissue is removed. Another surgical approach, needle aponeurotomy, involves using a small needle to divide the cords. It is less invasive and suitable for some patients with moderate contractures.
Post-treatment Rehabilitation
Post-treatment rehabilitation is crucial. Physiotherapy helps restore strength, mobility, and function. Hand splints may be used during recovery to maintain extension and prevent recurrence. Without rehab, stiffness may return, and hand function may remain limited.
The timing of treatment of Dupuytren’s contracture matters. If intervention is delayed until the contracture is severe, the outcomes are often less favourable. Some patients may never regain full extension of the fingers, even after surgery. Early treatment, when the fingers are still relatively mobile, tends to lead to better results.
Treatment of Dupuytren’s Contracture
In South Africa, access to advanced treatments like collagenase injections or minimally invasive surgery may be limited in the public sector. Private medical facilities and specialists in urban areas usually offer a wider range of treatment options. In rural communities, delays in diagnosis and referral can mean that patients only receive care at more advanced stages of the disease.
It’s important for patients and healthcare providers to discuss all available options, including the potential risks, costs, and recovery times. With the right plan, many people regain function and avoid long-term disability.
Successful treatment of Dupuytren’s contracture is possible when managed early, with a personalised approach and ongoing support from both medical professionals and rehabilitation services.
[Next: Complications of Dupuytren’s Contracture →]
